Will rickets lead to hunchback when grown up?

Written by Tong Peng
Pediatrics
Updated on March 16, 2025
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Rickets generally does not result in hunchback when one grows up, as rickets is a disease caused by a vitamin D deficiency leading to disturbances in calcium and phosphorus metabolism. If not cured before development is completed, it often leaves sequelae such as square skull, Harrison's groove, beaded ribs, as well as bow legs, knock knees, and pigeon chest. However, hunchback is mainly caused by developmental deformities of the thoracic and lumbar spine, and is not greatly related to a lack of vitamin D. However, it is also important to note that a deficiency in vitamin D can lead to osteoporosis, and if one does not maintain proper posture in daily life, such as bending the back while sitting, standing, or walking and not being able to stand straight, it may eventually lead to pathological curvature of the spine and thoracic vertebrae. Therefore, in daily life, it is still important to be conscious of using one’s lumbar and thoracic spine correctly to avoid developing a hunchback over time.

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The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.

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What is the fundamental difference between rickets and tetany?

Rickets is a type of vitamin D deficiency disease, primarily caused by insufficient vitamin D in infants, children, or adolescents, leading to disorders in calcium and phosphorus metabolism. It is a chronic nutritional disease characterized by skeletal lesions, mainly manifesting as changes in the fastest growing parts of the skeleton, such as square skull, pigeon chest, funnel chest, bow legs, and knock knees, among other symptoms. On the other hand, tetany is primarily due to hypocalcemia and its manifestations differ; it does not exhibit the skeletal changes seen in rickets but primarily presents as spasms or cramps in the hands and feet. Thus, this constitutes their fundamental difference.

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How to correct skeletal deformities in rickets?

The treatment of skeletal deformities due to rickets primarily targets the underlying disease, utilizing high doses of vitamin D supplementation. Mild skeletal deformities can recover spontaneously after treatment or correct themselves during a child's growth. The deformed or painful areas must be immobilized until the medication takes significant effect, which could take weeks or months. For moderate cases of bowlegs or knock-knees, small splints can be used for nighttime immobilization, and massage can be used for correction. For severe cases of bowlegs or knock-knees, patients can wear specially made orthopedic shoes. Permanent deformities may be corrected later through osteotomy.

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Rickets are more commonly seen at a few months old.

Rickets often presents with square skull in babies older than 8 to 9 months. A normal baby’s skull is round and without angles. The square skull seen in rickets is due to a calcium deficiency in the bones, leading to poor development of cartilage and inability for bone deposition and calcification. This results in a large amount of osteoid deposition under the periosteum of the frontal, parietal, and occipital bones, thus forming angular shapes and a squared skull. Besides square skull, rickets can also manifest as various other skeletal abnormalities at different ages, including "ping pong ball" skull, funnel chest, pigeon chest, bracelet sign, rosary sign, X-shaped legs, and O-shaped legs.

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What foods should not be eaten with rickets?

Patients with rickets should not eat some cereal foods, such as millet, rice, wheat, corn, and other foods. Cereal foods also contain vitamin D and calcium, and eating too much of these foods can exacerbate the disease. Patients with rickets should eat more light, low-fat, and easily digestible foods. They should control the intake of high-fat content daily and avoid eating stimulating and spicy foods. At the same time, they should increase their intake of vitamins, encourage the child to eat more fruits and vegetables to ensure an adequate supply of vitamins, and patients can also exercise more. More physical activity can help boost the immune system.